The present disclosure relates to dialysis and in particular to effluent sampling test for peritoneal dialysis.
Prescribing a dose of dialysis fluid for peritoneal dialysis (“PD”) patients is based typically on results from a peritoneal equilibration test (“PET”) developed originally by Dr. Zbylut J. Twardoski. The PET can be performed on a routine basis or when a nurse or clinician requests that a PET be performed. In current practice, patients have to travel to a dialysis center, so that a trained nurse or clinician can perform the PET in a manually intensive operation. A typical PET regime requires the nurse or clinician to take numerous solution samples over the course of approximately four to five hours.
If the nurse or clinician requests an effluent sample (for peritonitis testing, for a PET or for any desired reason) from a first drain, patients using known PD cyclers have to remain awake and collect the effluent sample at the proper sequence in therapy manually. The patient or clinician also has to open and close clamps manually at appropriate times during therapy to prevent contamination of the effluent sample.
Alternatively, if the clinician requests that an effluent sample (for adequacy testing or for any desired reason) be taken from the patient's total drain solution (all drain cycles combined), the patient has to perform an extra step at the end of therapy. This extra step requires the patient to pour fluid from a relatively large drain bag or container (e.g., fifteen liters) into a smaller effluent sample bag. The effluent sample bag or container may be connected to a Y in the drain line so that sterility is not an issue. Sometimes however the drain container is not connected to the drain line, meaning that the patient could spill the effluent sample when attempting to pour it into the separate container. Further, pouring fluid into a separate container can lead to contamination.
Still further, patients are sometimes requested to bring their entire effluent sample bag to a dialysis clinic to ensure an adequate sample volume is taken. This bag is heavy and cumbersome. Also, a disadvantage of bringing the entire drain bag is that the drain bag is typically diluted with several hundred milliliters of fresh dialysis solution due to priming and flushing of a disposable set at the beginning of therapy. The addition of the fresh dialysis fluid to the overall drain container can skew the effluent sampling results.
Accordingly, an improved apparatus and method for performing a PET and for effluent sampling generally is needed for PD.